恩格列净对早期糖尿病肾脏病患者肾脏保护作用研究  

Study on the renal protective effect of engliflozin in patients with early diabetes nephropathy

作　　者：姜国良 周淑娇 王萍[2] Jiang Guoliang;Zhou Shujiao;Wang Ping(Department of Endocrinology,Nanxiang Hospital,Jiading District,Shanghai 201802,China)

机构地区：[1]上海市嘉定区南翔医院内分泌科,201802 [2]上海市浦东新区浦南医院内分泌科

出　　处：《中华保健医学杂志》2023年第1期55-57,共3页Chinese Journal of Health Care and Medicine

基　　金：上海市嘉定区卫生和计划生育委员会(JDKW-2019-W23)。

摘　　要：目的观察恩格列净对2型糖尿病早期糖尿病肾脏病(DKD)患者白蛋白尿、血压等指标的影响,探讨其对DKD患者的肾脏保护作用。方法 选取2019年3月~2021年5月150例血糖控制不佳的早期DKD患者,随机数表法分为两组,恩格列净组在原降糖方案基础上增加恩格列净,对照组增加西格列汀,均治疗24周。比较两组患者入组时及治疗24周后体重、体质量指数(BMI)、血糖、血压、血脂、肾功能、血尿酸、尿微量白蛋白/肌酐比值(UACR)变化。观察患者不良反应。结果 剔除脱落病例后,对照组73例、恩格列净组71例患者完成研究。治疗前两组体重、BMI、SBP、DBP、FPG、HbA1c、TC、TG、UACR、eGFR、Scr、SUA差异无统计学意义(P> 0.05)。治疗24周后,两组SBP、DBP、FPG、HbA1c低于治疗前,差异有统计学意义(P <0.05)。恩格列净组体重、BMI、UACR和SUA低于同组治疗前,UACR和SUA低于对照组,差异均有统计学意义(P <0.05)。两组不良反应发生率无统计学意义(χ^(2)=0.428,P=0.512),但恩格列净组发生泌尿生殖道感染的比例较高。结论 对于早期糖尿病肾脏病患者,恩格列净可减少白蛋白尿、降低尿酸水平,起到肾脏保护作用。Objective To observe the effect of engliflozin on albuminuria and blood pressure in patients with early diabetes mellitus and diabetes nephropathy(DKD)and explore its renal protective effect.Methods 150 early DKD patients with poor blood glucose control were studied.Randomized number was divided into two groups.Engliptin was added to Engliptin group on the basis of the original hypoglycemic regimen,and Sigliptin was added to the control group.All patients were treated for 24 weeks.The changes of body weight,BMI,blood glucose,blood pressure,blood lipids,renal function,blood uric acid and urinary microalbumin/creatinine ratio(UACR)were compared between the two groups at the time of admission and 24 weeks after treatment.Observe the adverse reactions of patients.Results After removing the exfoliated cases,73 patients in the control group and 71 patients in the engegliptin group completed the study.There was no significant difference in body weight,BMI,SBP,DBP,FPG,HbA1c,TC,TG,UACR,eGFR,Scr,SUA between the two groups before treatment(P>0.05).After 24 weeks of treatment,SBP,DBP,FPG and HbA1c in the two groups were lower than those before treatment,with significant difference(P<0.05).The body weight,BMI,UACR and SUA in the engegliptin group were lower than those in the same group before treatment,and the UACR and SUA were lower than those in the control group,with significant differences(P<0.05).The incidence of adverse reactions in the two groups was not statistically significant(χ^(2)=0.428,P=0.512),but the incidence of genitourinary tract infection in women in the engegliptin group was high.Conclusion For patients with early diabetes kidney disease,enaglitazone can reduce albuminuria and uric acid level,and play a renal protective role.

关 键 词：恩格列净 早期 糖尿病肾脏病 白蛋白尿 肾脏保护 

分 类 号：R587[医药卫生—内分泌]